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经尿道膀胱肿瘤圈套切除术(TUSnBT)联合结石篮取出术:一种在内镜下处理乳头状膀胱病变的新型省时技术。

Trans-Urethral Snare of Bladder Tumor (TUSnBT) with Stone Basket Retrieval: A Novel Time-Saving Technique in the Endoscopic Management of Papillary Bladder Lesions.

作者信息

Adam Ahmed, Sookram Jayveer, Bhattu Amit Sattish, Wadee Reubina, Perera Marlon, Lawrentschuk Nathan

机构信息

Department of Urology, Helen Joseph Hospital, University of the Witwatersrand, Johannesburg, South Africa.

Department of Paediatric Urology, Rahima Moosa Mother & Child (Coronation) Hospital, University of the Witwatersrand, Johannesburg, South Africa.

出版信息

Curr Urol. 2018 Jun;11(4):189-195. doi: 10.1159/000447217. Epub 2018 Mar 30.

Abstract

BACKGROUND

To assess if trans-urethral snare of bladder tumor (TUSnBT) with subsequent stone basket retrieval can be used as an effective, time-saving adjunct resection technique for papillary bladder lesions.

METHODS

Via standard cystoscopy, TUSnBT was performed using a standard endoscopic polypectomy snare with subsequent tumor extraction utilizing a standard stone retrieval basket, when lesions were more than 10 mm in diameter. Smaller lesions were removed with the polypectomy snare. Standard trans-urethral resection of bladder tumors (TURBT) of the tumor bed was performed post TUSnBT. Histological assessment was performed and assessed separately per session.

RESULTS

In total, 18 papillary lesions, measuring between 9 and 26 mm, were resected via TUSnBT. Operative TUSnBT time, ranged between 10 and 60 seconds duration per lesion. No significant postoperative morbidity was experienced by patients within this cohort. Histo-pathological assessment revealed adequate muscle representation in 83.3 % of TUSnBT grouped sessions assessed.

CONCLUSION

TUSnBT with stone retrieval basket retrieval is a feasible method in selected papillary bladder lesions, and may be coupled with standard TURBT resection techniques. This method is less time consuming and would prove beneficial in select lesions. It may also be beneficial to assist with reducing the resection time or inadvertent bladder perforation encountered during the conventional TURBT.

摘要

背景

评估经尿道膀胱肿瘤圈套切除术(TUSnBT)联合结石篮取出术是否可作为一种有效、省时的乳头状膀胱病变辅助切除技术。

方法

通过标准膀胱镜检查,当病变直径大于10mm时,使用标准内镜息肉圈套器进行TUSnBT,随后用标准结石取出篮取出肿瘤。较小的病变用息肉圈套器切除。TUSnBT术后对肿瘤床进行标准经尿道膀胱肿瘤切除术(TURBT)。进行组织学评估,并逐例单独评估。

结果

总共通过TUSnBT切除了18个直径在9至26mm之间的乳头状病变。每个病变的TUSnBT手术时间为10至60秒。该队列中的患者术后均未出现明显并发症。组织病理学评估显示,在评估的TUSnBT分组病例中,83.3%的病例有足够的肌肉组织。

结论

TUSnBT联合结石篮取出术对于选定的乳头状膀胱病变是一种可行的方法,并且可以与标准TURBT切除技术相结合。这种方法耗时较少,在选定的病变中可能证明是有益的。它也可能有助于减少传统TURBT期间遇到的切除时间或意外膀胱穿孔。

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